Clinicopathological correlations in a series of adult patients with non-alcoholic fatty liver disease

Possible correlations among clinical data, serum aminotransferase levels and histological features were assessed in a series of 37 adult patients with non‐alcoholic fatty liver disease (NAFLD), consisting of nine patients with fatty liver (FL) and 28 with non‐alcoholic steatohepatitis (NASH). In eac...

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Bibliographic Details
Published in:Pathology international 2010-02, Vol.60 (2), p.87-92
Main Authors: Fotiadu, Anastasia, Gagalis, Asterios, Akriviadis, Evangelos, Kotoula, Vassiliki, Sinakos, Emmanouil, Karkavelas, Georgios, Hytiroglou, Prodromos
Format: Article
Language:English
Subjects:
Adult
Aged
aminotransferases
Aspartate Aminotransferases - blood
fatty liver
Fatty Liver - blood
Fatty Liver - pathology
Female
Humans
Immunohistochemistry
Male
microgranulomas
Middle Aged
non-alcoholic fatty liver disease
non-alcoholic steatohepatitis
ROC Curve
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Summary:Possible correlations among clinical data, serum aminotransferase levels and histological features were assessed in a series of 37 adult patients with non‐alcoholic fatty liver disease (NAFLD), consisting of nine patients with fatty liver (FL) and 28 with non‐alcoholic steatohepatitis (NASH). In each liver biopsy, the NAFLD activity score (NAS) and the stage of fibrosis were determined. Additionally, the number of Kupffer cell aggregates (microgranulomas) per centimeter of biopsy length (MG/cm ratio) was assessed on immunohistochemical stains for CD68 antigen. Definite NASH (NAS ≥ 5) was strongly correlated with serum aspartate aminotransferase (AST) level (P= 0.003), stage of fibrosis (P= 0.003) and age (P= 0.014). On multivariate analysis, age >46 years and AST level above normal values were found to be independent clinical predictors of established NASH. The MG/cm ratio increased from control liver to FL to NASH (P < 0.001), and was correlated with the NAS (P= 0.003) and with the stage of fibrosis (P= 0.004), but not with the serum aminotransferase levels. In conclusion, persistent AST elevation in patients with suspected NAFLD should be an indication for liver biopsy, in order to determine the severity of necroinflammatory activity and the stage of fibrosis. Microgranuloma counting may represent a useful complementary marker of necroinflammatory activity in patients with NAFLD.
ISSN:1320-5463
1440-1827
DOI:10.1111/j.1440-1827.2009.02489.x